Compare the four nursing homes you selected based on reported cases of the development of new pressure ulcers.

Nursing homes have become a viable option for geriatric patients who require routine care and need help performing basic activities of daily living, with about 3.3 million patients residing in nursing homes in the United States (CMS, 2010). While nursing homes provide care and services to patients, problems can arise resulting in reduced quality of care and, in some cases, illness and morbidity. The severe implications of pressure ulcers make them a major concern for elders residing in nursing homes. The Centers for Medicare & Medicaid Services estimate that 7.5% of nursing home residents have pressure ulcers and about 82,000 patients develop them each year (CMS, 2010). In your role as the advanced practice nurse, you must understand factors that contribute to the incidence of pressure ulcers in order to improve patient outcomes. For this Discussion, you examine the prevalence of pressure ulcers in nursing homes and develop strategies for increasing awareness and reducing incidence.

To prepare:

•Review Chapter 36 of the Flaherty and Resnick text and Chapter 12 of the Holroyd-Leduc and Reddy text.
•Select four nursing homes in your community and/or neighboring communities. Research and locate reports on these nursing homes through organizations such as Centers for Medicare & Medicaid Services.
•Compare the four nursing homes you selected based on reported cases of the development of new pressure ulcers.
•Think about factors in the nursing home setting that contribute to pressure ulcer issues, such as patient activity, nutrition, or the number of staff available to care for patients.
•Research guidelines for the prevention of pressure ulcers. Think about how you might increase awareness among nursing home staff about the incidence and consequences of pressure ulcers in patients.
Post on or before Day 3 a brief description of the four nursing homes you selected from your community and/or neighboring communities. Compare these four nursing homes based on the reported cases of new pressure ulcers. Then, explain factors in the nursing home setting that might contribute to incidence of pressure ulcer issues. Finally, based on guidelines for the prevention of pressure ulcers, explain how you might increase awareness among nursing home staff about the incidence and consequences of pressure ulcers in patients.
Readings
•Flaherty, E., & Resnick, B. (Eds.). (2011). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (3rd ed.). New York, NY: American Geriatrics Society.
?Chapter 36, “Pressure Ulcers and Wound Care” (pp. 283–294)

This chapter describes the phases of pressure ulcers and causes of pressure ulcer formation. It also examines assessment, treatment, and management strategies for pressure ulcers at different stages.
?Chapter 43, “Dermatologic Diseases and Disorders” (pp. 334–345)

This chapter examines the impact of aging and photoaging on the skin and risk factors for dermatologic disorders. It also describes characteristics of dermatologic disorders including inflammatory and autoimmune skin conditions, ulcers, infections and infestations, benign growths, and skin cancer.
•Holroyd-Leduc, J., & Reddy, M. (Eds.). (2012). Evidence-based geriatric medicine: A practical clinical guide. Hoboken, NJ: Blackwell Publishing Ltd.
?Chapter 12, “Preventing and treating pressure ulcers” (pp. 155–165)

This chapter presents methods for diagnosing, treating, and preventing pressure ulcers in older adults. It also examines noninvasive ways to diagnose infection in chronic wounds.
•Burr, S. (2012). Identifying common lesions and rashes in the elderly. Nursing & Residential Care, 14(5), 239–242.
Retrieved from the Walden Library databases.

This article examines strategies for assessing and diagnosing common lesions and rashes in the elderly. It also identifies management strategies for treating and preventing these skin conditions.
•Centers for Medicare & Medicaid Services. (2013). Nursing homes. Retrieved from http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/NHs.html

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